Background
The aim of this study is to describe a new surgical procedure to plicate the anterior bundle of the medial collateral ligament (aMCL) into its humeral footprint using a suture anchor, and to present the results of a clinical series.
Methods
Eight patients with posttraumatic medial elbow pain and signs of medial elbow instability underwent aMCL plication with suture anchors and decompression of the ulnar nerve. Arthroscopic evaluation permitted to define signs of minor medial elbow instability; a 70°-scope was used to document from an intra-articular point of view the aMCL status. The patients were then retrospectively evaluated with the Oxford Elbow Score (OES), Mayo Elbow Performance Score (MEPI) and single-assessment numeric evaluation (SANE) by an independent examiner.
Results
In all cases, the 70°-scope allowed direct visualization of the aMCL. Lateral subluxation of the coronoid process into the trochlea was observed in all patients. Postoperative median SANE was 50 [35–74.5] points; postoperative median OES was 17 [15.5–31.5] points; postoperative median MEPI was 65 [57.5–72.5] points. None of the patients reported further episodes of medial elbow instability or pain and all patients returned to normal daily activities.
Conclusions
The 70°-scope arthroscopic evaluation of the joint allows a direct evaluation of the aMCL status and stability. Lateral subluxation of the coronoid process into the trochlea was observed and can be considered a sign of minor medial elbow instability. Mini-open suture anchor aMCL plication is an original technique that enables an anatomic and minimally invasive ligament retension.